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Independents' Day

Bounce-backs from the Baltics


For the avoidance of doubt, I am absolutely not a ranting xenophobic/racist/UKipper/whatever and anyone who thinks otherwise can sod off back where they came from. But the thing is, I have a learning need, and to explain it I might just come across as ranty, xenophobic etc.

So. I have a cohort of Eastern European patients. Most are absolutely fine and dandy, but a small minority consistently seem to value my opinions and management of their ailments about as much as they appreciate stepping on a fresh and steaming dog poo.

This may be a cultural thing, to do with the way their native healthcare systems work. Or maybe I really am just a crap GP. After all, to be honest, plenty of my non Eastern European patients also seem to rate my clinical acumen some way below Dr Google’s, or their next-door-neighbour’s. But the key difference seems to be that my dissatisfied Eastern European punters have a tendency to react by popping over to their own particular Eastern European country, having an unnecessary scan revealing lots of incidentalomas and then, on their return, dumping the report in my lap for me and the trusty NHS to sort out.

They do this with an expression so smug that it saves them actually having to articulate: ‘Told you so, now send me to a proper doctor.’

Now I think it through, though, my indigenous unhappy Essex patients actually do much the same thing. But they at least save on travel and accommodation by simply waltzing off to the local DGH where, these days, a whole body MRI is integrated into the ‘Welcome to A&E’ doorframe. The only saving grace is that, while the report that plops into my inbox for me to ‘do the needful’ is perplexing, ambiguous and confusing, it is, at least, not written in Lithuanian*. And it’s all very well for the BMA to advise us to be more robust about our bounce-backs, but that’s tricky when you’re trying to sell the concept to a Dr Vaitkevicius of Vilnius University Hospital**.

So you probably think my aforementioned learning need is something like, what should I do about asymptomatic renal cysts picked up on MRI, or how can I convincingly dissuade patients from unnecessary scans, or what can I do to stop hospital investigating indiscriminately? But it isn’t. My learning need is actually working out what ‘Šis pacientas turi nepaaiškintą bendrą tulžies latako išsiplėtimą, prašau, būtinai’ means.

*If you think I’m being Lithuaniaist, I refer you to my opening para. Please insert another Eastern European country of your choice.

**If this person exists, and you’re reading this, it’s not actually you, okay?

Dr Tony Copperfield is a jobbing GP in Essex


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Readers' comments (7)

  • Totally agree.

    It's all about the lower threshold to consult, to be referred for unnecessary investigation, to see a 'specialist', but then what would one expect when everything is free at the point of use.

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  • There is nothing racist about accepting how cultural differences can make our jobs more challenging and I think you've been brave to raise this. I had someone bring their very well child in who I diagnosed with gastroenteritis (and a mild case at that) through history and exam. When I said I wasn't doing any tests they were extremely angry. When I asked what tests they wanted they didn't know but demanded I did some as that's what doctors in their country did! They then stormed out. How can we manage that?

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  • Sorry Tony ,I don't know what it means but I'll look it up on Vikipedija.

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  • This patient has an unexplained enlargement of the bile duct . Please do the necessary .

    Ps any Turkish translation and I'm your man

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  • You are not being 'Lithuaniaist' My parents were Lithuanian although I was born and bred here. You are just stating the facts , this is not racist. There are cultural differences and I have also noticed this problem. There should be a rule if you request the test then this should be managed by at least the requesting country , after all they bothered to visit there in the first place.

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  • James, please send a warning letter that such behavior is not tolerated and that this is the first and last letter that they will be receiving. The next time this happens they will be asked to re-register. the key thing is that the vast majority as all people are absolutely lovely and are grateful for what we do.

    Rudeness and disrespect is never cultural and it is actually an insult to their home nations to ever think so.

    Tony you have to hold your ground. if they still insist then offer them an opinion privately if they so choose. The other way round is that you can request an advice letter from a consultant.

    we have difficult enough issues trying to refer sick and unwell patients into hospital than to be wasting our colleagues and our own time. That is not racist. we must save the racism label for those that do actually deserve it

    - anonymous salaried!

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  • Healthy Cynic

    You've obviously sorted out one DEN - how to find those foreign characters on a keyboard!. Bang it in your appraisal folder Tony. And send your 360* assessment to those doctors in Vilnius!

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